How Claims and Appeals Proceed Under Workers’ Compensation Law

by | Aug 12, 2015 | Lawyers and Attorneys

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Workers’ compensation law identifies the legal requirements of all employers. Any business owner who employs more than one employee is required to purchase workers’ compensation insurance. It doesn’t matter if the employees are related to the business owner; this requirement still applies. A failure to comply with these laws could lead to fines as well as litigation.

How Workers’ Compensation Works
After an employee-based injury, the employee must report the injury to their employer. When necessary, the employer must contact emergency services. In cases in which the employee is able to transport himself or herself to the hospital, the employer provides them with workers’ compensation paperwork.
The doctor assigned to their case has a ten-day window to file their findings with the insurance company. The doctor must determine the full recovery time and specify if the injury prevents the employee from working. If the identified condition is a long-term injury, the doctor must outline the necessary care.

After the Forms Are Filed
After the doctor and human resources department files the paperwork, a claim’s adjuster is assigned to the claim. They must evaluate the employee’s injuries. They compare this condition to the guidelines for workers’ compensation. If the injury qualifies, the employee is notified of the starting date for their benefits. These benefits include payment for medical care and a percentage of the employee’s wages.

If the Claim Is Denied
Employees with severe injuries have a right to appeal any ideal of benefits. Under workers’ compensation law, they have a right to compensation for medical costs and lost wages. However, if they also lose their job due to these injuries, their attorney may seek further civil action on their behalf.

If the injuries produced a permanent injury or disability, the employee is entitled to a settlement. This settlement should reflect their potential earnings for the rest of their lives. The attorney should calculate these earnings based on the employee’s age, medical conditions, and overall health.

Workers’ compensation is a policy that helps to pay for medical treatment for injured employees. Too often employers deny these benefits to cut costs. When this happens, the employee becomes the victim of unfair circumstances.

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